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Rodriguez-Cartes SA, Zhang Y, Mayorga ME, Swann JL, Allaire BT. Evaluating the potential impact of rubella-containing vaccine introduction on congenital rubella syndrome in Afghanistan, Dem. Republic of Congo, Ethiopia, Nigeria, and Pakistan: A mathematical modeling study. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002656. [PMID: 38227558 PMCID: PMC10791005 DOI: 10.1371/journal.pgph.0002656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 11/30/2023] [Indexed: 01/18/2024]
Abstract
We assessed the potential impact of introducing rubella-containing vaccine (RCV) on congenital rubella syndrome (CRS) incidence in Afghanistan (AFG), Democratic Republic of Congo (COD), Ethiopia (ETH), Nigeria (NGA), and Pakistan (PAK). We simulated several RCV introduction scenarios over 30 years using a validated mathematical model. Our findings indicate that RCV introduction could avert between 86,000 and 535,000 CRS births, preventing 2.5 to 15.8 million disability-adjusted life years. AFG and PAK could reduce about 90% of CRS births by introducing RCV with current measles routine coverage and executing supplemental immunization activities (SIAs). However, COD, NGA, and ETH must increase their current routine vaccination coverage to reduce CRS incidence significantly. This study showcases the potential benefits of RCV introduction and reinforces the need for global action to strengthen immunization programs.
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Affiliation(s)
- Sebastian A. Rodriguez-Cartes
- Edward P. Fitts Department of Industrial & Systems Engineering, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Yiwei Zhang
- Operations Research Program, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Maria E. Mayorga
- Edward P. Fitts Department of Industrial & Systems Engineering, North Carolina State University, Raleigh, North Carolina, United States of America
- Operations Research Program, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Julie L. Swann
- Edward P. Fitts Department of Industrial & Systems Engineering, North Carolina State University, Raleigh, North Carolina, United States of America
- Operations Research Program, North Carolina State University, Raleigh, North Carolina, United States of America
| | - Benjamin T. Allaire
- RTI International, Research Triangle Park, North Carolina, United States of America
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Asrat B, Shimelis T, Assefa AA, Hussen S. Seroprevalence of rubella virus infection among antenatal care clients of Halaba Town public health facilities, southern Ethiopia. Sci Rep 2023; 13:7220. [PMID: 37137969 PMCID: PMC10156672 DOI: 10.1038/s41598-023-34444-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 04/30/2023] [Indexed: 05/05/2023] Open
Abstract
Rubella virus infection during pregnancy has several effects on the developing fetus. However, little is known about the epidemiology of the infection in Ethiopia. A cross-sectional study was conducted to assess the seroprevalence of rubella virus infection on consecutive 299 pregnant women attending antenatal care clinics in public health facilities in Halaba Town, Southern Ethiopia. Structured questionnaires were used to collect information on socio-demographic and reproductive characteristics. Venous blood samples were collected, and sera were tested for anti-rubella IgM and IgG using the enzyme-linked immunosorbent assay. Anti-rubella IgG and IgM were detected in 265 (88.6%) and 15 (5.0%) of 299 participants, respectively. Pregnant women in their first trimester [crude odds ratio (cOR) = 4.26; 95% CI (1.47, 12.4)] were at increased risk of having anti-rubella IgM compared to those in their second and third trimesters. Urban residents [cOR = 4.06; 95% CI (1.94, 8.47)] were with a higher percentage of IgG positivity compared to rural residents. Anti-rubella IgG positivity was higher in housewives [cOR = 2.94; 95% CI (1.07, 8.04)] compared to self-employed women. Our findings showed a high prevalence of rubella virus exposure, and considerable percentages of recent infection and susceptible women to contracting the infection, emphasizing the importance of congenital rubella syndrome in the research area.
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Affiliation(s)
- Bedilu Asrat
- Southern Nations, Nationalities, and Peoples' Region Public Health Institute, Hawassa, Ethiopia
| | - Techalew Shimelis
- School of Medical Laboratory Sciences, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.
| | - Abiyu Ayalew Assefa
- Department of Public Health, Hawassa College of Health Sciences, Hawassa, Ethiopia
| | - Siraj Hussen
- School of Medical Laboratory Sciences, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
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Armah NB, Sagoe KW, Nuamah M, Yawson AE, Nartey ET, Essuman VA, Yao NA, Baidoo KK, Fynn JA, Tetteh D, Gyamaa-Yeboah E, Seshie M, Boamah I, Nkyekyer K. Rubella virus IgM and IgG antibodies with avidity in pregnant women and outcomes at a tertiary facility in Ghana. PLoS One 2022; 17:e0279733. [PMID: 36584202 PMCID: PMC9803272 DOI: 10.1371/journal.pone.0279733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 12/14/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Congenital rubella syndrome (CRS) is a recognised cause of childhood deafness and blindness caused by the transplacental transmission of rubella virus during pregnancy. Women in the reproductive age group, and by extension their unborn babies may therefore be at increased risk. The prevalence of Rubella virus specific IgM and IgG antibodies, including IgG avidity, was determined in pregnant women attending the antenatal clinic at a Teaching Hospital in Ghana. METHODS One hundred and forty-five women in their second and third trimesters of pregnancy from the outpatient clinic were recruited over a period of 2 months after written informed consent was obtained. Study participants completed a questionnaire and venous blood drawn for IgM, IgG, and avidity testing using SERION ELISA (SERION® Immunologics, Würzburg, Germany). Babies of mothers with positive or indeterminate IgM and low avidity IgG antibodies were offered specialist cardiological, ophthalmological or hearing assessment during follow up. RESULTS One hundred and twenty-eight (88.3%) had only IgG antibodies, 5 (3.4%) had IgM and IgG antibodies, while 12 (8.3%) had no antibodies. No patient had IgM antibodies alone. Ten women (6.9%) had indeterminate levels of IgM antibodies. Majority of the women had high avidity IgG antibodies, while 5 (3.4%) had low avidity antibodies. No patient had IgM with low avidity antibodies. There was no statistical association between socio-demographic factors and the presence of IgM, IgG (low or high avidity) antibodies. Of all the children followed, none had the clinical definition of CRS. CONCLUSIONS Consistent with the World Health Organization elimination strategy for measles and rubella viruses, non-immune women in the reproductive age group should be vaccinated. The immunization programme should be expanded to include teenagers and adults. Though Congenital Rubella Syndrome was not detected, the risk still remains.
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Affiliation(s)
- Naa Baake Armah
- Department of Obstetrics and Gynaecology, Korle Bu Teaching Hospital, Accra, Ghana
- * E-mail: (NBA); (KWS)
| | - Kwamena W. Sagoe
- Department of Medical Microbiology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Legon, Ghana
- * E-mail: (NBA); (KWS)
| | - Mercy Nuamah
- Department of Obstetrics and Gynaecology, Korle Bu Teaching Hospital, Accra, Ghana
| | - Alfred E. Yawson
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Edmund T. Nartey
- Center for Tropical Clinical Pharmacology and Therapeutics, University of Ghana Medical School, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Vera A. Essuman
- Department of Surgery, University of Ghana Medical School, University of Ghana, Accra, Ghana
| | - Nana-Akyaa Yao
- Cardiothoracic Centre, Korle Bu Teaching Hospital, Accra, Ghana
| | - Kenneth K. Baidoo
- Department of Surgery, University of Ghana Medical School, University of Ghana, Accra, Ghana
| | - Jemima Anowa Fynn
- Department of Surgery, University of Ghana Medical School, University of Ghana, Accra, Ghana
| | - Derrick Tetteh
- Department of Medical Microbiology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Eva Gyamaa-Yeboah
- Department of Obstetrics and Gynaecology, Korle Bu Teaching Hospital, Accra, Ghana
| | - Makafui Seshie
- Department of Medical Microbiology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Isaac Boamah
- Department of Medical Microbiology, University of Ghana Medical School, College of Health Sciences, University of Ghana, Legon, Ghana
| | - Kobina Nkyekyer
- Department of Obstetrics and Gynaecology, Korle Bu Teaching Hospital, Accra, Ghana
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Vueba A, Faria C, Almendra R, Santana P, Sousa MDC. Seroepidemiology study of Cytomegalovirus and Rubella in pregnant women in Luanda, Angola: geospatial distribution and its association with socio-demographic and clinical-obstetric determinants. BMC Infect Dis 2022; 22:124. [PMID: 35123414 PMCID: PMC8818202 DOI: 10.1186/s12879-022-07087-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 01/26/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Both CMV and Rubella virus infections are associated with the risk of vertical transmission, fetal death or congenital malformations. In Angola, there are no reports of CMV and Rubella studies. Therefore, our objectives were to study the seroprevalence of anti-CMV and anti-Rubella antibodies in pregnant women of Luanda (Angola), identify the risk of primary infection during pregnancy and evaluate the socio-demographic risk factors associated with both infections. METHODS A prospective cross-sectional study was conducted from August 2016 to May 2017. Specific anti-CMV and anti-Rubella antibodies were quantified by electrochemiluminescence and demographic and clinical data were collected using standardized questionnaire. Bivariate and multivariate logistic regression analysis were used to quantify the effect of clinical and obstetric risk factors on virus seroprevalence. RESULTS We recruited 396 pregnant women aged from 15 to 47. Among them, 335 (84.6%) were immune to both CMV and Rubella virus infections, while 8 (2.0%) had active CMV infection and 4 (1.0%) active RV infection but none had an active dual infection. Five women (1.2%) were susceptible to only CMV infection, 43 (10.9%) to only RV infection, and 1 (0.3) to both infections. Multivariate analysis showed a significant association between Rubella virus infection and number of previous births and suffering spontaneous abortion. CONCLUSIONS Overall, this study showed that there is a high prevalence of anti-CMV and anti-Rubella antibodies in pregnant women in Luanda. It also showed that a small but important proportion of pregnant women, about 11%, are at risk of primary infection with rubella during pregnancy. This emphasizes the need for vaccination.
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Affiliation(s)
- Amélia Vueba
- Faculty of Pharmacy, University of Coimbra (FFUC), 3000-548, Coimbra, Portugal
| | - Clarissa Faria
- Faculty of Pharmacy, University of Coimbra (FFUC), 3000-548, Coimbra, Portugal
- Center for Neuroscience and Cell Biology (CNC), University of Coimbra, Coimbra, Portugal
| | - Ricardo Almendra
- Centre of Studies on Geography and Spatial Planning (CEGOT), Department of Geography and Tourism, University of Coimbra, Coimbra, Portugal
| | - Paula Santana
- CEGOT-Centre of Studies in Geography and Spatial Planning and Department of Geography and Tourism, Faculty of Arts and Humanities, University of Coimbra, Coimbra, Portugal
| | - Maria do Céu Sousa
- Faculty of Pharmacy, University of Coimbra (FFUC), 3000-548, Coimbra, Portugal.
- Center for Neuroscience and Cell Biology (CNC), University of Coimbra, Coimbra, Portugal.
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The Burden of Likely Rubella Infection among Healthy Pregnant Women in Abakaliki, Ebonyi State, Nigeria. Interdiscip Perspect Infect Dis 2022; 2022:5743106. [PMID: 35140784 PMCID: PMC8820899 DOI: 10.1155/2022/5743106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 01/12/2022] [Indexed: 11/17/2022] Open
Abstract
The first 140 days of pregnancy are critical as regards rubella virus infection because of the likelihood of a poor pregnancy outcome. This study was undertaken to investigate the likelihood of exposure to poor pregnancy outcomes due to seroprevalence of rubella among selected pregnant women attending Mile Four Hospital, Abakaliki, Ebonyi State, Nigeria. The seroprevalence of rubella immunoglobulin M (IgM) antibodies was investigated among pregnant women. A total of 187 sera samples collected from the women were screened for rubella virus IgM antibody using the enzyme-linked immunosorbent assay (ELISA). The results obtained were analyzed using SPSS. The chi square test was performed at a
value of 0.05 significance and at a 95% confidence interval. Of the 187 pregnant women, 35 (18.72%) were positive for the rubella virus. Pregnant women within 26–30 years of age had the highest prevalence (26.15%), while those aged 35–40 years had the least prevalence. Married women had the highest prevalence (20.0%), followed by singles (16.67%) and widows (15.38%), while divorced pregnant women recorded the least prevalence (9.20%). Pregnant women with no formal education were more predisposed to rubella virus (22.22%) infection compared to their educated counterparts. Occupationally, full-time housewives had the highest prevalence (24.26%). The infection rates seemed to wane as pregnancy advanced. The first trimester had the highest prevalence (21.88%), followed by the second trimester (18.84%) and the third trimester (17.44%). Pregnant women living in urban areas had higher IgM seroprevalence (20.18%) than those in rural areas (16.67%). Furthermore, grand multigravidas were more infected (22.73%) than primigravidas (14.52%) and multigravidas (20.39%). The seroprevalence of rubella in this study was high, and it calls for general surveillance and mass immunization of children and females of childbearing age in the area to help reduce the incidence of congenital rubella syndrome.
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Eyeberu A, Debella A, Balis B, Lami M, Tefera T, Getachew T. Burdens of Rubella and Cytomegalovirus infections among pregnant women in Africa: A systematic review and meta-analysis. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2022. [DOI: 10.1016/j.ijans.2022.100493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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AlShamlan NA, AlOmar RS, AlOtaibi AS, Almukhadhib OY, AlShamlan AA, Alreedy AH, Zabeeri NA, Darwish MA, Al Shammri MA. Seroprevalence of rubella virus among pregnant women: A 4-year registered-based study from family medicine and obstetric clinics in Saudi Arabia. Int J Clin Pract 2021; 75:e14156. [PMID: 33743553 DOI: 10.1111/ijcp.14156] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 03/17/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES This study aimed to determine rubella virus infectivity and immune status in pregnant females who visited the family medicine and obstetrics clinics at a large hospital in Saudi Arabia, and to identify the possible predictors of rubella susceptibility. METHODS This registered-based, cross-sectional study included pregnant, aged between 18 and 50 years old, who presented for the first antenatal visit between 2017 and 2020. Data on sociodemographic, antenatal characteristics and serological results were collected. Chi-Squared or Fisher's Exact test and t tests were used for bivariate analysis followed by the multivariable logistic regression model. RESULTS A total of 4328 pregnant were included in the study. Seroprevalence of rubella immunity was 76.41%. Positive rubella IgM antibody was identified in 1.21% of those who performed the test (17/1409). Odds of susceptibility were decreased with an increase in age (OR = 0.96, 95% CI = 0.95-0.97) and in non-Saudis' (OR = 0.44, 95% CI = 0.36-0.54). CONCLUSIONS Approximately 24% of pregnant were susceptible to rubella virus infections in this study. Screening females of child-bearing age and reimmunisation of susceptible cases before pregnancy are suggested. Further studies to investigate the impact of applying this policy in premarital screening are recommended.
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Affiliation(s)
- Nouf A AlShamlan
- Department of Family and Community Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Reem S AlOmar
- Department of Family and Community Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Amani S AlOtaibi
- Department of Obstetrics and Gynaecology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Omar Y Almukhadhib
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Abeer A AlShamlan
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Abdullah H Alreedy
- Department of Family and Community Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Najwa A Zabeeri
- Department of Family and Community Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Magdy A Darwish
- Department of Family and Community Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Malak A Al Shammri
- Department of Family and Community Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Liu H, Shi W. WITHDRAWN: Effect of maternal rubella virus infection on fetal cardiac function and neural development by color doppler ultrasound (cardiography) information technology. Neurosci Lett 2020:S0304-3940(20)30479-1. [PMID: 32599316 DOI: 10.1016/j.neulet.2020.135209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/17/2020] [Accepted: 06/24/2020] [Indexed: 10/24/2022]
Abstract
This article has been withdrawn at the request of the Editor-in-Chief. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.
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Affiliation(s)
- Haixia Liu
- Third Department of Ultrasound, Cangzhou Central Hospital, Cangzhou City 061001, Hebei Province, China
| | - Wei Shi
- Third Department of Ultrasound, Cangzhou Central Hospital, Cangzhou City 061001, Hebei Province, China.
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Taku NA, Ndze VN, Abernathy E, Hao L, Waku-Kouomou D, Icenogle JP, Wanji S, Akoachere JFKT. Seroprevalence of rubella virus antibodies among pregnant women in the Center and South-West regions of Cameroon. PLoS One 2019; 14:e0225594. [PMID: 31751431 PMCID: PMC6872161 DOI: 10.1371/journal.pone.0225594] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 11/07/2019] [Indexed: 11/18/2022] Open
Abstract
Rubella infection in early pregnancy can lead to miscarriages, fetal death, or birth of an infant with congenital rubella syndrome (CRS). In Cameroon, like in many developing countries, rubella surveillance is not well-established. The aim of this study was to determine the prevalence of rubella virus specific antibodies among pregnant Cameroonians. We conducted a cross-sectional study for rubella infection among pregnant women attending antenatal clinics in the Center and South-West regions of Cameroon. Demographic data and blood were collected and tested for rubella specific antibodies (IgG and IgM), and for the IgM positive cases, IgG avidity and real time PCR was done. From December 2015 to July 2017, 522 serum samples were collected and tested from pregnant women. The seroprevalence of rubella specific IgG was 94.4%, presumably due to immunity induced by wild-type rubella virus. The seroprevalence of rubella specific IgM was 5.0%, possibly indicating rubella infection. However, IgG avidity testing of the IgM positive cases detected high avidity IgGs, ranging from 52.37% to 87.70%, indicating past rubella infection. 5.6% (29/522) of the participants had negative results for IgG to rubella virus, indicating susceptibility to rubella infection. None of the participants had received a rubella containing vaccine (RCV), but 51% (266/522) of the pregnant women lived in a house with a child with records of at least one dose of RCV. Rubella virus RNA was not detected in the urine of any IgM positive case. Findings from this study show that rubella infection is significant in Cameroon. Some pregnant women are still susceptible to rubella infection. For a better management of rubella infection in pregnancy in Cameroon, consideration should be taken to investigate for IgG-avidity test in cases with positive rubella IgM result to distinguish between recent from past rubella infection.
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Affiliation(s)
- Nadesh Ashukem Taku
- Department of Microbiology and Parasitology, Faculty of Science, University of Buea, Buea, Cameroon
- * E-mail:
| | - Valantine Ngum Ndze
- Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon
| | - Emily Abernathy
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - LiJuan Hao
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Diane Waku-Kouomou
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
- IHRC Inc, Atlanta, Georgia, United States of America
| | - Joseph P. Icenogle
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Samuel Wanji
- Department of Microbiology and Parasitology, Faculty of Science, University of Buea, Buea, Cameroon
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